Interprofessional Education and Practice: Creating Leaders and Opportunities

for Clinical Learning

MODULE 6Collaborative Leadership

 

Funded by the Australian Government Office for Learning and Teaching

Learning outcomes

• Explore your organisation’s readiness for interprofessional

education/interprofessional practice• Understand key approaches to collaborative change

leadership

Catalysing change: collaborative change leadership

(ehpic™, 2013)

IPE/IPP cornerstone of health human resource strategy

Advancing Teamwork in Healthcare will require a significant paradigm shift. It will require all stakeholders to be involved, engaged & willing to collaborate for change.

www.healthforceontario.ca

Critical success factors in Ontario

• IPC champion – Assistant Deputy Minister of Health Human Resources – reporting to both Education & Health

• Accreditation standards for interprofessional education

• Legislative regulatory changes across professions – Bill 179

• Government funding provided for interprofessional education to support universities & colleges

• Innovative partnership grants between education and practice awarded

US Advisory Committee on Interdisciplinary Community-Based Linkages• Adopt accreditation standards for interprofessional

education

• Conduct evaluations to further assess effectiveness of interprofessional education and practice

• Implement knowledge-sharing resource to disseminate best practices

• Facilitate establishment of reimbursement policies that support interprofessional practice

• Establish standards for information systems & data elements to facilitate collaboration

• Provide interprofessional faculty development & curriculum development resources to health professions schools

Is your organisation ready?

Defining organisational culture

“… shared philosophies, ideologies, values, assumptions,

beliefs, expectations, attitudes and norms in organizations.”

“... is nurtured and shaped gradually over a period of time,

reflected in terms of collaboration, trust and learning, and it

can shape the behaviours of people in that organization.”

(Zhu & Engels, 2013, p. 2)

Culture

• Culture is embedded in artifacts

• Artifacts are tangible things that demonstrate culture through language used, organisational structures, leadership models, practices etc.

(Martin, 2002; Schein, 1996)

Artifacts (observable)

Values (what ought to be)

Shared Assumptions(beliefs that guide action)

What would it take to transform your setting

to one that supports interprofessional

education and interprofessional practice?

Cultural change

IP-COMPASS: Interprofessional Collaborative Organization Map and Preparedness Assessment Tool

A guided self-assessment, quality improvement framework to help understand the types of organisational values, structures, processes, practices & behaviours required to create an environment that is conducive to interprofessional education

http://www.youtube.com/watch?v=dfBJRSw2xeg

https://nexusipe.org/

The IP-COMPASS Framework

The 4 constructs:

– The organisation is committed to interprofessional practice (IPC)

– The organisation is committed to interprofessional education

– Structures and supports exist to facilitate interprofessional education

– Structures and supports exist to facilitate interprofessional practice

Construct one: the organisation/unit

1. Commitment to interprofessional collaboration

Examples1.2 Interprofessional collaboration is part of strategic planning

1.3 Time, people & money are committed to interprofessional collaboration

1.4 Leaders promote interprofessional collaboration among team members

1.7 The effectiveness of interprofessional collaboration is measured

Example (1.2) Interprofessional collaboration is part of strategic planning in the organisation

When this attribute is strong…IPC is almost

always considered when strategic-level decisions

are made that impact (a) how care providers work

together and (b) how clients/patients are cared for.

These decisions might be at any level (e.g.,

organisation, program, department or unit).

Evidence…

• IPC is in formal planning documents, for example…

Is IPC in the organisation’s overarching strategic plan

and/or ‘scorecards’?

• In our clinical setting, this attribute is…

Absent Weak Adequate Strong

Using the IP-COMPASS Tool

• Apply the IP-COMPASS to your context to reflect upon its

readiness for interprofessional education and practice

• Choose the construct that most stands out to you (if time

permits start another)

• Facilitators are assigned at each table to assist you.

Large group debrief

1) Describe your experience using IP-COMPASS.

2) What strengths did you identify demonstrating interprofessional education and practice?

Large group debrief

Now consider how you can lead the use of this tool in your

own setting.

Leading from where you stand

What do we mean by leadership?

Margaret Wheatley defines a leader as:

“Anyone who sees an issue or opportunity and

chooses to do something about it .”

The real work of leaders is to help people discover the

power of seeing.

(Wheatley, 2009, p.144)

Change curve

Kotter’s 8 steps for transformational change

1. Establish a sense of urgency

2. Form a powerful guiding coalition

3. Create a vision

4. Communicate the vision

5. Empower others to act on the vision

6. Plan for & create short-term wins

7. Consolidate improvements & produce more change

8. Institutionalise new approaches – embed into organisation’s culture

(www.kotterinternational.com)

Collaborative leadership

• Asking questions

• Pausing and reflecting

• Sensing what is needed

• Modelling collaboration

(Adapted from Scharmer’s (1997) Theory U)

Appreciative leadership

Appreciative Inquiry

Involves the art & practice of asking questions that

strengthen a system’s capacity to heighten positive

potential

Empowers others to act on a vision

(Cooperrider & Whitney, 1999)

Questions as a strategy

• The change has started simply by asking the question

• Questions can be used:

- to gain and sustain momentum

- to foster reflection

“Organizations grow in the direction of what they are

repeatedly ask questions about and focus their attention on”

(Bernard Mohr, 2001)

Appreciative inquiry 4-D cycle

DISCOVERWhat do we already

know that we will build on

DREAMWhat do we want to

create? What difference do we want to make?

DESIGNHow will we make

this difference happen?

DESTINYHow do we adapt & re-adapt as the new

story is created?

Paired interviews - what would interprofessional education and practice look like at its best?

• Instructions in your resource file

• Partner with the person next to you

• Nominate person A and person B

• A interviews B using the questions in the interview instruction sheet

• B interviews A using the questions in the interview instruction sheet

• Come back to your group to share

Be curious

Summary

• Paired interviews allow everyone to have a voice

• Often generate a lot of energy

• New possibilities come to light when you listen to your

own & others stories

• Sharing stories can establish common ground

• Stories can hint at what could be created (co-created)

Appreciative leadership

5 core strengths of an appreciative leader:

Inquiry – ask for others to contribute – sends message of valuing them

Illumination – show their strengths & how they can best contribute

Inclusion – collaboration, give sense of belonging

Inspiration – provide with a direction

Integrity – let people know they’re expected to do their best & that they

can trust others to do the same

(Whitney, Troston-Bloom & Rader, 2010)

Systems thinking to understand complex situations

• A system is something that maintains its existence and

functions through the interaction of its parts

• When dealing with a system you never do just one thing –

system effects cross boundaries

(Collopy, 2009)

Leaders with multiple frames

A leader who can draw upon multiple frames is a more

comprehensive leader than one who relies exclusively upon

one for all situations.

(Bolman & Deal, 1991)

Lessons learned

Structural: Goals & efficiency

- Loss of clarity & stability

+ Realigning, clear direction, accountability, communicating policies & structures

(Bolman & Deal, 1991)

Lessons learned

Human Resource: Human needs

- Anxiety & uncertainty

+ Facilitation, empowerment & involvement

(Bolman & Deal, 1991)

Lessons learned

Political: Scarce resources

- Conflict and loss of control

+ Networking, negotiating, compromising & building coalitions

(Bolman & Deal, 1991)

Lessons learned

Symbolic:

- Loss of meaning

+ Rituals, stories & ceremonies to celebrate achievements

(Bolman & Deal, 1991)

Using multiple change approaches

Effective change

Collaborative leadership (Scharmer, 1997)

Appreciative Leadership

(Whitney et. al., 2010)

Multiple leadership

frames (Bolman & Deal, 1991)8 Step process

(Kotter, www.kotterinternational.co

m)

Support for the production of this resource has been provided by the Australian Government Office for Learning and Teaching. The views expressed in this Power Point do not necessarily reflect the views of the Australian Government Office for Learning and Teaching.  

Unless otherwise noted, content on this site is licensed under the Creative Commons Attribution-ShareAlike 4.0 Unported License